Clobetasol dipropionate 0.05% versus testosterone propionate 2% topical application for severe vulvar lichen sclerosus.
OBJECTIVE
Our goal was to evaluate short-term (3 months) and long-term (1 year) treatment of vulvar lichen sclerosus, by comparing topical application of testosterone propionate 2% in petrolatum with the corticosteroid clobetasol dipropionate 0.05%.


METHODS
There were 20 women in each treatment group. The patients' symptoms and the gynecologist's examination findings were recorded before treatment, at 3 months, and at 1 year after initiation of therapy.


RESULTS
The symptomatic (subjective) effect of clobetasol treatment was similar to that of testosterone at the 3-month follow-up (p < or = 0.34), although objectively the signs of lichen sclerosus had improved more in the clobetasol group (p < or = 0.033). Both symptoms and signs were significantly more improved in the clobetasol-treated group at the 1-year follow-up examination (p < or = 0.02). Seventy percent of women treated by testosterone discontinued treatment because of a lack of response, whereas only 10% of the women treated with clobetasol stopped the treatment for that reason (p < or = 0.00042).


CONCLUSIONS
Clobetasol is more effective than testosterone in the treatment of women with lichen sclerosus, especially in the long term.
Bornstein
J
J
Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel.
Heifetz
S
S
Kellner
Y
Y
Stolar
Z
Z
Abramovici
H
H
D000287:Administration, Topical; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology; D002990:Clobetasol / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D018459:Lichen Sclerosus et Atrophicus / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D013739:Testosterone / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014845:Vulvar Diseases / Q000188:drug therapy* / Q000473:pathology; D014846:Vulvar Neoplasms / Q000175:diagnosis / Q000453:epidemiology
D000893:Anti-Inflammatory Agents; D013739:Testosterone; D002990:Clobetasol